2型糖尿病患者血清透明质酸与颈动脉内膜中层厚度的相关性研究

Correlation between serum hyaluronic acid and carotid intima media thickness in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者血清透明质酸(HA)与颈动脉内膜中层厚度(CIMT)的相关性,以明确血清HA在T2DM大血管病变中的实验室诊断价值。方法选取我院T2DM患者144例,其中T2DM无并发症组33例,T2DM大血管并发症组47例,T2DM非大血管并发症组64例,另选健康体检者30例作为健康对照组(NC组)。测定血清HA、CIMT、超敏C反应蛋白(hs-CRP)、血脂、空腹血糖水平。结果 T2DM无并发症组、T2DM大血管并发症组、T2DM非大血管并发症组血清HA均高于NC组(P<0.05);T2DM大血管并发症组血清HA显著高于T2DM非大血管并发症组和T2DM无并发症组(P<0.01);血清HA与FPG、Hb A1c、HOMA-IR及CIMT呈正相关(r=0.853、0.711、0.779、0.328,P均<0.01),与HDL-C呈负相关(r=-0.749,P=0.000);CIMT与HA、FPG、Hb A1c、HOMA-IR及hs-CRP呈正相关(r=0.328、0.404、0.384、0.361、0.180,P<0.05),与HDL-C呈负相关(r=-0.303,P=0.000)。结论 T2DM及其血管并发症患者血清HA显著升高,且血清HA升高水平和CIMT显著相关,可能与糖代谢紊乱导致血管损伤影响细胞外基质HA产生有关,血清HA可以作为T2DM及其大血管并发症的辅助诊断指标。

Objective To investigate the correlation between serum hyaluronic acid（HA） and carotid intima-media thickness（CIMT） in patients with type 2 diabetes mellitus（T2DM）, and to determine the diagnostic value of serum HA in the laboratory diagnosis of T2 DM and its vascular complications. Methods 144 cases of T2 DM patients in our hospital were selected, including 33 cases of T2 DM without complications, 47 cases of T2 DM macrovascular complications, 64 cases of non macrovascular complications of T2 DM. 30 cases of healthy persons were selected as healthy control group（NC group）. The serum levels of HA, CIMT, high sensitive C reactive protein（hs-CRP）, blood lipid and fasting blood glucose were measured. Results The serum levels of HA in T2 DM without complications group, T2 DM with macrovascular complications group, non macrovascular complications group were higher than that of NC group（P〈0.05）; Serum HA in T2 DM macrovascular complications group was significantly higher than that of non macroangiopathy group and T2 DM without complications group（P〈0.01）; Serum HA was positively correlated with FPG, Hb A1 c, HOMA-IR and CIMT（r=0.853, 0.711, 0.779, 0.328, P〈0.01）, and negatively correlated with HDL-C（r=-0.749, P=0.000）; CIMT was positively correlated with HA, FPG, Hb A1 c, HOMA-IR and hs-CRP（r=0.328, 0.404, 0.384, 0.361, 0.180, P〈0.05）, and negatively correlated with HDL-C（r=-0.303, P=0.000）. Conclusion Serum HA significantly increased in patients with T2 DM and its vascular complications, and elevated serum levels of HA and it had significantly correlation with CIMT. These may be related to the disorder of glucose metabolism and effect on HA of the ex-tracellular matrix, and serum HA can be used as an assistant diagnostic index for T2 DM and its vascular complications.